News Release

CHAPEL HILL -- The National Cancer Institute has awarded the University of North Carolina at Chapel Hill’s Lineberger Comprehensive Cancer Center a Specialized Program in Research Excellence – or SPORE – grant in gastrointestinal cancers.

The five-year grant is for approximately $11.5 million; UNC has one of four GI SPOREs in the nation.

Gastrointestinal cancers include tumors of the esophagus, stomach, pancreas, liver, colon and rectum (among others) and represent the second leading cause of cancer death nationwide.

"This grant will allow us to translate laboratory findings into novel approaches for prevention, early detection and therapy of gastrointestinal cancers," said Dr. Joel Tepper, the GI SPORE principal investigator. "An understanding of the biology of these tumors will make future advances possible. This means the prospect of improved management and tailored therapies for patients."

Tepper is a professor and chairman of the School of Medicine’s department of radiation oncology and a member of UNC Lineberger.

"The best science is now conducted collaboratively," said Dr. Bill Roper, UNC’s vice chancellor for medical affairs and School of Medicine dean, "with laboratory scientists working side by side with clinicians to use the specific information gleaned from new technologies in a way that benefits patients directly. Through this collaboration, more targeted therapies are developed – smarter drugs that aim specifically at a molecular pathway rather than the entire cell."

This spirit of collaboration has helped development of clinical trials under way that build on a new understanding of how the cancer cell works and the approaches researchers can use to kill tumor cells more effectively, said Tepper. Examples of these compounds are proteosome inhibitors, which limit certain enzymes’ abilities to break down proteins that prevent cancer cells from growing, he added.

Other studies in the SPORE grant will analyze other molecular pathways in these tumors to determine how to alter the activity of those pathways for patient benefit.

"The UNC Lineberger Comprehensive Cancer Center, with its hallmark collaborative approach to cancer research and care, is uniquely positioned to extend this paradigm to benefit the citizens of North Carolina and beyond," said Roper.

The SPORE program aims to take findings in basic science laboratories and epidemiological studies and apply them in clinical settings and then take information from the clinic and population studies and study that in the lab setting, said Tepper. "The give and take and the interaction among the clinic, laboratory and the population is what makes this grant opportunity so exciting."

This grant will poise UNC to take advantage of new scientific findings to develop and test novel therapies targeting specific cellular functions and interactions, said Tepper.

Genomics research, for example, will be used to learn and describe the genetic composition of tumors, he added. Knowing the genetic profile of a tumor and the variations among groups of tumors will allow clinicians to understand and predict what does and doesn’t work for an individual’s disease. This also may lead to the development of therapeutic approaches for certain tumors having unusual molecular "signatures" that would not be uncovered in any other way.

"We used to try a treatment and if it didn’t work, we would abandon it," said Tepper. "But now we have the opportunity to find out if a therapy may not work because of an individual tumor’s molecular makeup. With this knowledge we can start with an approach designed for the individual patient and his tumor with a different drug or a different combination of therapies. If we had this information before starting therapy, we could better manage the patient’s cancer. Gaining that understanding and flexibility is our goal."

Environmental factors including diet, exercise and occupational exposure can contribute to the formation of gastrointestinal cancers. New technology and approaches will allow UNC researchers to study how these environmental exposures interact with an individual’s genes and how that interaction may be modified.

"It is known that African Americans have worse survival from colorectal cancer," said Dr. Robert Sandler, director of UNC’s Center for Gastrointestinal Biology and Disease and a SPORE leader. "It is not known whether this is due to access to medical care, variation in treatment or differences in the biology of their tumors.

"The SPORE has the potential to shed light on this problem by carefully examining medical therapy, as well as the molecular characteristics of cancers in a large number of African-American and white cancer patients."

Sandler’s studies are based on large populations in multiple areas of North Carolina and include tissue samples that can be analyzed. Under his leadership, UNC scientists already are obtaining exceptionally detailed information on the structure and process of colorectal cancer care, as well as demographic information about study subjects who will be monitored to determine outcomes over five years.

The resulting database will provide a unique resource for future studies on racial disparities and other factors in colon and rectal cancers.

"We will know what happened to a specific patient and can therefore probe these samples to determine the significance of molecular signatures in these tumors," said Sandler, also a professor of medicine and UNC Lineberger member. "This knowledge can then be put to use with newly diagnosed patients to better design their therapy. This project also addresses racial disparities in GI cancers."

UNC Lineberger now holds two SPORE grants; the first was awarded in 1992 for breast cancer study.

"A great strength of our two SPORE grants, and, in fact, all the center’s cancer research is the close collaboration among the health affairs schools, particularly the School of Public Health and the School of Medicine," said Dr. H. Shelton Earp, professor of medicine and pharmacology and UNC Lineberger director.

"This stimulates cooperation between those who study individual patients and those who study populations of patients. Each informs the other’s work, and with the emergence of a nationally recognized cancer genetics group at UNC, both SPOREs are strengthened."

Other GI SPORE grants are at Vanderbilt-Ingram Cancer Center in Nashville, Tenn.; the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore; and the University of Arizona at Tucson.

To learn more about the individual UNC SPORE projects, click on http://unclineberger.org/.

- 30 -

UNC Lineberger contact: Dianne Shaw, (919) 966-5905 or dgs@med.unc.edu

UNC News Services contact: Deb Saine, (919) 962-8415 or deborah_saine@unc.edu